Revenue Cycle Specialist

About This Role

This specialist role is responsible for managing and improving the financial processes related to patient accounts, billing, insurance claims, payment posting, and collections. The position ensures accurate and timely reimbursement while maintaining compliance with healthcare regulations and organizational policies, working collaboratively with patients, insurance providers, and internal departments to resolve billing issues and optimize revenue cycle performance.

Responsibilities

• Review and process patient accounts accurately and efficiently
• Submit insurance claims electronically and follow up on unpaid or denied claims
• Verify insurance eligibility, benefits, and authorization requirements
• Post payments, adjustments, and denials into billing systems
• Investigate and resolve billing discrepancies and claim rejections
• Communicate with insurance companies regarding claim status and appeals
• Maintain confidentiality and compliance with HIPAA regulations
• Monitor accounts receivable aging reports and prioritize collection efforts
• Document all account activity thoroughly and accurately
• Collaborate with billing team to improve billing accuracy and workflow efficiency
• Stay informed on payer guidelines, coding updates, and healthcare billing regulations

Requirements

• High school diploma or GED required; associate or bachelor's degree preferred
• Minimum of 2

-3 years of experience in medical billing, healthcare finance, or revenue cycle operations required

• Knowledge of insurance claims processing, coding basics, and reimbursement methodologies
• Experience with electronic medical records (EMR) and billing software
• Strong attention to detail and organizational skills
• Excellent verbal and written communication skills
• Ability to manage multiple tasks and meet deadlines in a fast-paced environment

Nice to have:

• Experience with Medicare and HMO insurance payers
• Knowledge of denial management and appeals processes
• Understanding of healthcare compliance standards and billing regulations
• Customer service and problem-solving abilities

Benefits

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance